Community Antibiotic Use, Susceptibility and ResisTance Among Patients With Urinary Tract Infections (CAST-UTI)

Comparison of Community and Hospital Antibiotic Use Practices, Susceptibility and ResisTance and Determinants of Care Seeking Among Patients With Urinary Tract Infections (CAST-UTI)

1. General objective

   This pilot study aims to compare the prevalence of resistance in bacteria causing UTIs among patients seeking care outside the hospital settings (CDROs) to the WHO-GLASS data.

2. Specific objectives

2-1 Primary objectives:

• Determine the resistance profiles of uropathogens and carriage strains from patients with uncomplicated UTIs attending community drug retail outlets (CDRO's) and in hospitals*.
• Compare the resistance profiles of the uropathogens from patients with uncomplicated UTIs attending CDROs and hospitals to those in the WHO-GLASS database.
• Explore the patient pathway and its impact on antibiotic use among patients presenting to CDROs and hospitals with uncomplicated UTIs.
• Determine the appropriateness of antimicrobial use in the treatment of uncomplicated UTIs among patients presenting to CDROs and hospitals

2-2 Secondary objectives:

• Compare resistance profiles among the uropathogens from patients from two neighbourhoods in Kampala.
• Examine environmental samples between the study sites to determine the presence of antibiotic residues and AMR in two neighbourhoods in Kampala.

Inclusion criteria:

• Must have one or more of the following clinical presentations regardless of age:

acute (< 2 weeks) dysuria. increased urinary urgency and frequency, irritation, discharge. increased lower abdominal pain or discomfort and sometimes gross haematuria.

• In elderly patients with pre-existing urinary symptoms: increased acute urinary changes.

Exclusion criteria:

• People without symptoms of UTI.